Executive - CRM

Medi Assist; Mumbai; On-site; INR 350,000 - 500,000; Full time

Job summary

Medi Assist is seeking an Executive for JD Account Management focused on client servicing and claims handling in Mumbai. The role involves receiving and validating claim documents, coordinating with teams for registration and cashless processes, and ensuring timely responses to employees and corporates.

Key responsibilities include maintaining TAT, escalating issues per the matrix, and coordinating with insurers, enrolment teams, and regional agents to resolve queries efficiently.

Qualifications

• Receive and check claim documents for completeness and advise employees regarding pending documents.
• Track and control documents to ensure TAT of claims/cards as per SLA.
• Provide feedback from Insurers and Corporates.
• Identify additional revenue opportunities from existing Corporates.
• Respond to employee queries via email.
• Maintain weekly reports on claims, queries and TAT.
• Escalate issues per the escalation matrix.
• Attend to other assignments as required.
• Respond to queries from corporate employees over the phone.
• Coordinate with inward team for claim receiving and registration.

Responsibilities

• Client Servicing and handling of day-to-day claim related inquiries.
• Coordinate with inward team for claim receiving and claim registration.
• Liasoning with enrolment team to register policy for cashless and reimbursement.
• Coordinate with regional agents and customers for claim related queries and settlement.
• Answering incoming calls of all customers/agents/internal team and tracking queries.
• Maintain weekly reports on claims and queries and the TAT of the same.
• Escalate issues as per the escalation matrix and provide timely updates.
• To attend to any other assignments assigned from time to time.

Job description

JD Account Management- Executive

Job Responsibilities: Client Servicing

• Receive and check claim documents for completeness and advice employees
• regarding pending documents, if any.
• Track and control documents to ensure TAT of claims/cards as per SLA.
• Feedback from Insurers and Corporates.
• Additional revenue opportunities from existing Corporates.
• Respond to queries from the employees of the corporate through e-mails.
• Maintain weekly reports on claims and queries and the TAT of the same
• Escalate issues as per the escalation matrix.
• To attend to any other assignments assigned to you from time to time.
• Respond to queries from the employees of the corporate over Phone
• Maintain weekly reports on claims and queries and the TAT of the same
• Escalate issues as per the escalation matrix.
• To attend to any other assignments assigned to you from time to time.

Transactional Activities:

• To coordinate with inward team for claim receiving and claim registration
• Allocating new generated claims to processing team for action
• Liasoning with enrolment team to register the policy for cashless and reimbursement
• Coordination with regional agents, customers for claim related queries, settlement
• queries- cashless /reimbursement
• Answering incoming calls of all customers / agents / internal team
• Keep track of all customer queries with claim numbers and follow-up to verify that
• all queries are resolved.
• Coordinating with cashless / pre auth team to ensure cashless is granted within
• TAT and to provide timely claim status. Query letter / Settlement letter should be
• explained properly to customers / agents on queries and deductions.